Journal article
Racial/Ethnic and gender gaps in the use of and adherence to evidence-based preventive therapies among elderly Medicare Part D beneficiaries after acute myocardial infarction
Circulation (New York, N.Y.), Vol.129(7), pp.754-763
02/18/2014
DOI: 10.1161/CIRCULATIONAHA.113.002658
PMCID: PMC4351731
PMID: 24326988
Abstract
It is unclear whether gender and racial/ethnic gaps in the use of and patient adherence to β-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and statins after acute myocardial infarction have persisted after establishment of the Medicare Part D prescription program.
This retrospective cohort study used 2007 to 2009 Medicare service claims among Medicare beneficiaries ≥65 years of age who were alive 30 days after an index acute myocardial infarction hospitalization in 2008. Multivariable logistic regression models examined racial/ethnic (white, black, Hispanic, Asian, and other) and gender differences in the use of these therapies in the 30 days after discharge and patient adherence at 12 months after discharge, adjusting for patient baseline sociodemographic and clinical characteristics. Of 85 017 individuals, 55%, 76%, and 61% used angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, and statins, respectively, within 30 days after discharge. No marked differences in use were found by race/ethnicity, but women were less likely to use angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and β-blockers compared with men. However, at 12 months after discharge, compared with white men, black and Hispanic women had the lowest likelihood (≈30%-36% lower; P<0.05) of being adherent, followed by white, Asian, and other women and black and Hispanic men (≈9%-27% lower; P<0.05). No significant difference was shown between Asian/other men and white men.
Although minorities were initially no less likely to use the therapies after acute myocardial infarction discharge compared with white patients, black and Hispanic patients had significantly lower adherence over 12 months. Strategies to address gender and racial/ethnic gaps in the elderly are needed.
Details
- Title: Subtitle
- Racial/Ethnic and gender gaps in the use of and adherence to evidence-based preventive therapies among elderly Medicare Part D beneficiaries after acute myocardial infarction
- Creators
- Julie C Lauffenburger - University of North Carolina at Chapel HillJennifer G RobinsonChristine Oramasionwu - University of North Carolina at Chapel HillGang Fang - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- Circulation (New York, N.Y.), Vol.129(7), pp.754-763
- DOI
- 10.1161/CIRCULATIONAHA.113.002658
- PMID
- 24326988
- PMCID
- PMC4351731
- NLM abbreviation
- Circulation
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Publisher
- United States
- Grant note
- T32 NR008856 / NINR NIH HHS
- Language
- English
- Date published
- 02/18/2014
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983995151302771
Metrics
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